Background The worldwide prevalence of overweight and obesity is at alarming levels. Nearly one in three children in Europe is overweight or obese. Disordered eating and body image concerns are equally widespread and increase risk for more chronic and severe weight-related problems. Research has shown that online interventions that address both healthy weight regulation and body image can reduce risk for eating disorders and obesity simultaneously and are feasible to implement in school settings. To date, evaluation and dissemination of such programs in Europe is scant. Methods The Healthy Teens @ School study is a multi-country cluster-randomized controlled trial (RCT) comparing the effectiveness of an unguided, online, multi-level intervention for promoting a healthy lifestyle and reducing problematic eating behavior, eating disorder and obesity risk among students aged 14 to 19 years with control condition. As part of the Horizon 2020 funded project ICare (GA No. 634757) the trial is conducted in Austria and Spain. Cluster randomization by school is used. The intervention is an adapted version of an evidence-based program developed in the USA (StayingFit). Participants of the intervention group are assigned to one of two possible program tracks based on the results of the initial online-assessment: Overweight adolescents are assigned to the “Weight Management” track emphasizing balanced eating and exercise for weight maintenance, and all other individuals are assigned to the “Healthy Habits” track which aims at promoting healthy habits related to e.g., nutrition, physical activity, sleep. The participants of both tracks work on ten modules (one 20–30 min module per week) during school hours and/or at home. Assessments are conducted at pre- and post-intervention, and at 6- and 12-months after baseline assessment. The primary outcome is intuitive eating, secondary outcomes are eating disorder symptomatology, body image concerns, body mass index, food intake, physical activity, self-esteem, stress coping, depression, and anxiety. Following the initial assessment, individuals in the control group do not have access to the prevention program but continue as normal and are only prompted to the assessments at all time points. At the end of the 12-month study they will get access to the program. Discussion The results from this study will add to the understanding of how to address eating and weight related problems in adolescents and will shed light on the feasibility of implementing online prevention programs in school routine in Austria and Spain. As part of the larger ICare project this RCT will determine how an adapted version of StayingFit is disseminated within Europe.

中文翻译：

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健康青少年@学校：评估和传播针对学校环境中青少年饮食失调和肥胖症的跨诊断预防干预措施。

背景 超重和肥胖的全球流行率处于惊人的水平。欧洲近三分之一的儿童超重或肥胖。饮食失调和身体形象问题同样普遍，并增加了更慢性和严重的体重相关问题的风险。研究表明，解决健康体重调节和身体形象的在线干预可以同时降低饮食失调和肥胖的风险，并且在学校环境中实施是可行的。迄今为止，欧洲对此类计划的评估和传播很少。方法 健康青少年@学校研究是一项多国整群随机对照试验 (RCT)，比较了无指导、在线、多层次干预在促进健康生活方式和减少有问题的饮食行为方面的有效性，控制条件下 14 至 19 岁学生的饮食失调和肥胖风险。作为 Horizo​​n 2020 资助项目 ICare（GA 编号 634757）的一部分，该试验在奥地利和西班牙进行。使用按学校分组随机化。该干预是美国开发的循证计划（StayingFit）的改编版本。根据初始在线评估的结果，干预组的参与者被分配到两个可能的计划轨道之一： 超重青少年被分配到“体重管理”轨道，强调平衡饮食和锻炼以维持体重，所有其他人被分配到分配到“健康习惯”轨道，旨在促进与营养、身体活动、睡眠等相关的健康习惯。两个轨道的参与者在上课时间和/或在家中学习十个模块（每周一个 20-30 分钟的模块）。在干预前和干预后以及基线评估后的 6 个月和 12 个月进行评估。主要结果是直觉饮食，次要结果是饮食失调症状、身体形象问题、体重指数、食物摄入量、身体活动、自尊、压力应对、抑郁和焦虑。在初始评估之后，对照组中的个人无法使用预防计划，但会继续正常进行，并且只会在所有时间点提示进行评估。在为期 12 个月的研究结束时，他们将获得该计划的使用权。讨论 本研究的结果将加深对如何解决青少年饮食和体重相关问题的理解，并将阐明在奥地利和西班牙的学校常规中实施在线预防计划的可行性。作为更大的 ICare 项目的一部分，该 RCT 将确定如何在欧洲传播改编版的 StayingFit。